Organization
ROGAN'S COUNTRY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN L ROGAN SR. RPH (OWNER, PHARMACIST)
(618) 342-6737
Entity
Organization
Contact information
Practice address
201 E COMMERCIAL, PULASKI, IL 62976
(618) 342-6737
(618) 342-6241
Mailing address
PO BOX 241, PULASKI, IL 62976-0241
(618) 342-6737
(618) 342-6241
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054013170
IL
333600000X
Pharmacy
Primary
054013170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120005231
MEDCO PROVIDER NO.
IL
01
—
1466704
NABP NO.
IL
05
—
327367483001
—
IL
Enumeration date
03/15/2006
Last updated
06/05/2012
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